Proportional Reasoning in Nursing Practice

Celia Hoyles, Richard Noss, Stefano Pozzi

We investigate how expert nurses undertake the calculation of drug dosages on the ward. This calculation is error-critical in nursing practice and maps onto the concepts of ratio and proportion. Using episodes of actual drug administration gleaned from ethnographic study, we provide evidence that experienced nurses use a range of correct proportional-reasoning strategies based on the invariant of drug concentration to calculate dosage on the ward instead of the single taught method they describe outside of the practice. These strategies are tied to individual drugs, specific quantities and volumes of drugs, the way drugs are packaged, and the organization of clinical work.

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